Modern volumetric imaging modalities may produce body images that are almost photo-realistic. Rendering techniques allow selected internal anatomy or pathology to be shown, but are also capable of rendering the skin surface. For example, computed tomography (CT) and magnetic resonance imaging (MRI) acquisitions can be rendered to produce highly realistic 3D images of the human body.
Although volumetric modalities enable excellent visualization of the skin surface, such visualization may not be clinically necessary in some cases. The purpose of a scan may more commonly relate to internal anatomy. In some such cases, visualization of the skin surface may be used for navigation purposes so that a user can navigate to particular body areas. However, navigation may not require a highly accurate representation of the skin surface.
Patient images produced from volumetric imaging modalities may be distributed in a variety of situations (as volumetric image data or as rendered images). Patient images may be distributed to clinicians, for example to referring clinicians or surgeons. Patient images may be displayed at multi-disciplinary team and case conference meetings. Patient images may be displayed in consultations with the patient and/or his or her family members. Patient images may be shown at professional or academic conferences.
The use of forensic CT images is also increasing. Forensic CT refers to CT that is carried out post-mortem. Forensic CT images may relate, for example, to victims of violent crime or deceased soldiers. Forensic CT images may be presented during court or other proceedings, in which case forensic CT images may be presented in front of, for example, the family of the CT subject. The presence of identifying features, for example facial features, in forensic CT images may cause distress.
In the USA, HIPAA (Health Insurance Portability and Accountability Act) requires that patient files be made anonymous before being distributed, including removal of ‘full-face photographs and any comparable images’. However, HIPAA does not address the use of volumetric imaging modalities in this context.
In the healthcare context, some groups are concerned about patient modesty issues, and may be dissatisfied with current levels of modesty in healthcare settings. Such groups could be dissatisfied if they were aware of the resolution and realism of imaging that is possible using modern volumetric imaging modalities. The display or distribution of images that include culturally sensitive areas (for example, breast, pelvis or genitals) may be of particular concern to such groups. Specific cultural and religious issues also exist. A patient's dissatisfaction with available levels of modesty may in some circumstances lead to delayed or omitted medical care, lawsuits, or general mistrust of the medical profession.
Some hospitals and clinics may publicize their consideration of patient modesty. During hospital examinations and procedures, efforts may be made to minimize periods of nudity and to provide some patient choice, for example choice of the gender of the clinician attending the patient. Nonetheless, some patients believe they are not treated with respect. Some patients claim that, in some cases, live video streams from the operating room or other images are used for training of students, and the unauthorized use of such images can be of particular concern to some patients.
Any area for which privacy or identification concerns exist (for example, the face) or any area for which modesty concerns exist (for example, breast, pelvis or genitals or other culturally sensitive areas such as upper arm, thigh or shoulder) may be referred to as a sensitive area.